Uterine cervical carcinoma: evaluation of pelvic lymph node metastasis with MR imaging.

Abstract

PURPOSE: To assess accuracy of magnetic resonance (MR) imaging in detection of pelvic node metastasis from uterine cervical carcinoma. MATERIALS AND METHODS: In 136 patients (aged 26-71 years [mean, 49 years]) with uterine cervical carcinoma seen between October 1990 and July 1992, maximum axial diameter (MAAD), minimum axial diameter (MIAD), and signal intensity enhancement ratio of positive nodes were measured. RESULTS: With MAAD of 1.0 cm, MR imaging had an accuracy of 90.4%, sensitivity of 62.2%, and specificity of 94.9% in detection of pelvic node metastasis. Mean MAAD and MIAD were 1.43 and 1.30 cm for true-positive nodes and 1.18 and 0.75 cm for false-positive nodes, respectively. Mean MAAD/MIAD was 1.09 for true-positive and 1.76 for false-positive nodes. With MIAD of 1.0 cm, MR imaging had an accuracy of 93.0% with 62.2% sensitivity and 97.9% specificity. No significant differences were noted in the degree of contrast enhancement between true-positive and false-positive nodes. CONCLUSION: The accuracy of MR imaging was fairly high in detection of pelvic node metastasis from uterine cervical carcinoma, and MIAD was a more accurate size criterion than MAAD.